Keep KALM and Shake Your Intrusions Away!

With Kalm, we have tried to address the anxiety that arises due to the uncertainty through a smart home monitoring system and an accompanying wearable which allows the user to see the status of the appliances remotely.

Contributors: Harri Lin, Rahul R, Angie Li, Bella Bai

Problem Overview

Almost 80% of people with Obsessive-Compulsive Disorder share symptoms of compulsive checking. Anxiety arising from such compulsions can be triggered by queues in their environment, specific routines and our user research showed that a significant population of people with OCD have their anxiety compounded when in a public environment. A few participants in our study had related symptoms and revealed that they were unable to leave their homes due to the uncertainty of whether they had locked their doors, switched off the lights or ensured that the stove was not on. There is also a difficulty that stems from a circumstance where the person with OCD is unable to distinguish between legitimate concerns and intrusive thoughts that hold no validity. The solution space for this demographic requires equal parts empathy and practicality.

Solution

With Kalm, we have tried to address the anxiety that arises due to the uncertainty through a smart home monitoring system and an accompanying wearable which allows the user to see the status of the appliances remotely. While realizing that there is no substitute for medical therapy, we propose a system designed to reduce the frequency of checking modeled on lessons from Exposure Response Therapy. By allowing the user to set a limit on the number of times they can view the status of their appliances per day we encourage them to take ownership and control of their lives.

The home appliances are synchronized with sensors that connect to the wearable and are able to show the live status of the home appliances. The users are free to choose the appliances they wish to monitor although we recommend limiting the usage to personal equipment. In our digital prototype, for example, these sensors are placed on the room door, window and stove.

The unique feature of the KALM design is the popup feature which gets activated when the user reaches the set limit of checks. An alert with a low-frequency vibration pops up on the screen of their wearable. Rather than displaying the live status of the appliances, a customized message is displayed which encourages the user to resist the intrusive thoughts and acts as a reminder about their intended self-development. The pop can be dismissed, much like their intrusive thoughts, by shaking the wearable. We intend to form a neuro-kinesthetic connection between the act of physically shaking the watch and overcoming the intrusive compulsion to check the device. A psychiatrist or the user could set the limit on the device, for example, allowing 10 times checking for each hour or gradually decreasing the number of times for a period of time. Until the new time period starts, the popup will show up every time the user tries to check on the device.

Paper Prototype, Testing Process, and Results

We started to build our paper prototype once we had a design in our minds. Below is an overview of our paper prototype.

After we designed our prototypes for the wristband and the phone app, we conducted usability tests with 3 participants. We anticipated the difficulty of reaching OCD patients during our user research phase and decided to conduct the usability test with 3 UW students under a controlled environment. These users were asked to give objective opinions based on a simulated stressful situation and asked our users to run through the prototype. Through narration, we were able to guide the users in a sufficiently equitable manner.

From our usability tests, we got some very helpful feedback from the participants. For the wristband, we originally wanted the screen to wake up in all red when there is a change in state of the monitored home appliance and the rectangular icons of the applicants were not clickable (see image below).

During the test process, we learned that making the screen all red induces anxiety. Thus, we replaced it with a text indicating that there was a status change in the appliance. In order to get rid of the false affordance, we decide to allow the users to click on each application’s status and show the most recent status change after users click. This provides additional reassurance for the user

In the phone app, we planned to give users customization options so that they can edit the message that appears on the wristband when they checked too frequently. However, this is not indicated in the setting page and confused the participants. We added a prompt for clarity as seen in the adjacent image.

Digital Mockup

Phone App for Setup : https://www.figma.com/file/wGe9Hbm5xJBvXnTDpTOYhc/KALM?node-id=24%3A8613

Wearable Device:

● When all application is at ideal status: https://www.figma.com/file/wGe9Hbm5xJBvXnTDpTOYhc/KALM?node-id=28%3A9260

● When something went off: https://www.figma.com/file/wGe9Hbm5xJBvXnTDpTOYhc/KALM?node-id=26%3A9230

● When patient check more than limit times: https://www.figma.com/file/wGe9Hbm5xJBvXnTDpTOYhc/KALM?node-id=26%3A9328

Description:

The two tasks are supported in the following ways:

Task 1: Reduce checking frequency

The common worry and cause of anxiety for some OCD patients is that the home appliances may not be in the ideal state. The necessary information to assure them can be obtained by interacting with the wristband. This is done in 3 steps:

1. Push the side button on the wristband to wake up the screen. If the screen is green, then it means everything is ok and the patient should relax. Since the OCD patient tends to check everything before they leave their home/car, the applications’ status stays ideal during the day. Thus, every time when they have the urge to check after they’ve already fixed everything, the home screen should always be green.
2. Push the side button again to see the detailed status of every application. Scroll up/down by turning the device crown to see all the applications.
3. Push the side button again to lock the screen.

Task 2: Allowing OCD patient to perform Inconspicuous behaviors

OCD patients wish to complete their rituals in public inconspicuously. With our wristband, their checking behaviors become inconspicuous as the interaction is limited to the button and the crown on the wearable. They are able to alleviate their concerns and also given the opportunity to make progress by actively confronting their compulsions

1. When the user has checked the wearable beyond the set limit, the wearable screen no longer displays the appliance status, rather it shows a screen with a message to motivate the user to “shake off the intrusive thoughts!”.
2. The user can shake their wrists and the screen will go off.
3. The system returns to normal functioning once a set time period has passed

Discussions of changes from preliminary mockup to the final mockup:

From some feedback that we got for our preliminary digital mockup, we decided to revise the wording on the data summary page in the phone app. Some feedback we received was that phrases like “you are doing 21% than yesterday” could have a negative connotation if there was an increase in the checking frequency instead.

We wanted to retain the core function of the design which was to inform the user about their habits while showing them the scope and possibility for improvement. The data summary page is an important part of this goal. In our redesign, we incorporated a suggestion to decrease the checking limit in the case that the user is showing improved levels of control and personal growth. Below, we elaborate two scenarios based on the user’s journey with the system.

Case A: the user is doing so well and has shown improvement which is measurable by the number of checks per day in the graph. In this scenario we motivate the user to decrease the checking limit. A button that links to the checking limit page appears encouraging the user to continue with the positive momentum

Case B: The user has faced some challenges which could be due to numerous circumstances and has either been hitting the checking limit or has shown increased anxiety relating to checking. Based on this data we encourage the user to maintain the positive spirits.

Summary

People with Obsessive-Compulsive Disorder suffer from crippling obsessions, 80% of whom have compulsive checking and some of them are often unable to leave home due to anxiety concerning their home appliances such as unclosed doors or windows. Enter kalm , a system which allows OCD patients to check the status of all the important appliances remotely on a wearable enabling them to go about their routine lives. The kalm wearable alerts users when they check the status too many times in a short period. Inspired by ERP therapy, kalm strives to decrease the number of such episodes by setting a checking limit with a customized message encouraging the user to confront and overcome their compulsion.